Prime Time

About the program

Prime Time is a multi-component youth development intervention for adolescent girls at high risk for pregnancy. Prime Time aims to reduce precursors of teen pregnancy including sexual risk behaviours, violent behaviours, and school disconnection. The intervention, involving one-on-one case management and peer leadership programming over an 18-month period, targets specific environmental, personal, and behavioural mediators of pregnancy risk.

Who does it work for?

Prime Time is designed for sexually active 13–17-year-old girls at high risk of pregnancy. Prime time has only been evaluated in the USA. Two randomized control trials were conducted with 106 participants (Sieving et al., 2012; 59 in the intervention group and 47 in the control group) and 253 participants (Sieving et al., 2013; 126 in the intervention group and 127 in the control group). Most participants in the 2012 study were 17 years old and most in the 2012 study were 15 years old. Most girls in both studies were African American and still attending high school. Most girls in the 2013 study received public assistance in the past year, however the majority in the 2012 study did not.

Prime Time has not been evaluated in Australia or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• Prime Time participants’ beliefs supporting birth control increased
• Prime Time participants’ perceptions of the importance of having sex for material reasons decreased after 24 months.
• Prime Time participants’ stress management skills improved
• Prime time participants condom use self-efficacy improved at the 18 month data collection time point*

No effect:

• The program had no effect on participants’ desire to use birth control
• The program had no effect on participants’ sexual & sexual risk communication with their partner
• The program had no effect on participants’ condom use self-efficacy* or sex refusal self-efficacy
• The program had no effect on participants’ sense of family or school connectedness
• The program had no effect on participants’ desire to use contraception with a partner or of participants’ perceptions of their partner’s desire to contraception
• The program had no effect on participants’ compulsions to have sex for relationship reasons
• The program had no effect on participants’ perceived pregnancy consequences
• The program had no effect on participants’ interpersonal skills

*The different outcomes between condom use self-efficacy between the 2012 and 2013 studies appears to be limited only to the single significant positive effect noted at the 18-month data collection time point in the 2013 study (which became nonsignificant again on measurement after 24 months). The authors do not report a reason for this result.

How effective is it?

Overall, Prime Time had mixed effects on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT)/quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects

How is it implemented?

Prime Time is a multi-component intervention delivered in person over the course of 18 months. Prime Time comprises three key components: case management, peer educator and leadership training and service learning.

Case management: Case managers attempted monthly visits with each intervention participant over the 18-month intervention period. One-on-one visits focused on core topics of emotional skills, healthy relationships, responsible sexual behaviours, and positive family, school, and community involvement.

Peer educator training (Just In Time): The purpose of the ‘Just In Time’ peer education training was to provide opportunities for positive peer, school, and community involvement by engaging participants as peer health educators. Just In Time training used a standardized 15-session curriculum addressing communication skills, stress management skills, conflict resolution skills, expectations, and skills for healthy relationships, understanding social influences on sexual behaviours, sexual decision-making, and contraceptive use skills. Through weekly homework activities, participants explored Just In Time topics with an adult family member and girls were instructed to reach and teach others in their lives. After completing the Just In Time, girls completed a seven-session practicum, choosing a topic from the Just In Time curriculum to teach, developed a lesson plan, practiced their teaching skills, taught 2 group sessions.

Service learning (It’s Our Time): The purpose of the ‘It’s Our Time’ service-learning component was to expand participants’ social-emotional skills and their real-world experience in civic engagement and leadership. It’s Our Time groups followed a standardized 3 x unit curriculum that included core elements of service learning: preparation, action, reflection, and celebration. Each implementation session included a group reflection activity highlighting the impact of service on recipients and relating service experiences to girls’ leadership skills and civic engagement.

How much does it cost?

The costs for Prime Time were not reported in the study.

Where does the evidence come from?

2 RCTs conducted in the USA with a sample of 106 people (Sieving et al., 2012) and 253 people (Sieving et al., 2013).

Further resources

Sieving, RE, Bernat, DH, Resnick, MD, Oliphant, J, Pettingell, S, Plowman, S, & Skay, C 2012, ‘A clinic-based youth development program to reduce sexual risk behaviors among adolescent girls: Prime Time pilot study’, Health Promotion Practice, vol. 13, pp. 462-471, DOI 10.1177/1524839910386011.

Sieving, RE, McRee, AL, McMorris, BJ, Beckman, KJ, Pettingell, SL, Bearinger, Garwick, AW, Oliphant, JA, Plowman, S, Resnick, MD, & Secor-Turner, M 2013, ‘Prime time: sexual health outcomes at 24 months for a clinic-linked intervention to prevent pregnancy risk behaviors’, JAMA Pediatrics, vol. 167, pp. 333-340, DOI 10.1001/jamapediatrics.2013.1089.

The following studies are particularly relevant to the Prime Time program:

Sieving, RE, McMorris, BJ, Beckman, KJ, Pettingell, SL, Secor-Turner, M, Kugler, K, Garwick, AW, Resnick, MD, & & Bearinger, LH 2011, ‘Prime Time: 12-month sexual health outcomes of a clinic-based intervention to prevent pregnancy risk behaviors’, Journal of Adolescent Health, vol. 49, pp. 172-179, DOI 10.1016/j.jadohealth.2010.12.002.

Sieving, RE, McMorris, BJ, Secor-Turner, M, Garwick, AW, Shlafer, R, Beckman, KJ, Pettingell, SL, Oliphant, JA, Seppelt, AM 2013, ‘Prime Time: 18-month violence outcomes of a clinic-based intervention’, Prevention Science, vol. 15, pp, 460-472, DOI 10.1007/s11121-013-0387-5.

Shlafer, RJ, McMorris, BJ, Sieving, RE, Gower, AL 2012, ‘The impact of family and peer protective factors on girls’ violence perpetration and victimization’, Journal of Adolescent Health, vol. 52, pp. 365-371, DOI 10.1016/j.jadohealth.2012 .07.015.